Get GeriPal Email Updates

Search This Blog

Posts

Tremendous amount of exciting new data coming out of one of our nation's oldest palliative care services: Massachusetts General Hospital (MGH) just celebrated a 20 year anniversary. Please see the links below to recent articles and posts, including new studies about early palliative care in bone marrow transplant and early stage GI cancers coming out of MGH.

In today's podcast we interview Vicki Jackson, chief of the palliative care service at Massachusetts General Hospital, the service that provided the palliative care intervention in these trials. Vicki is known as one of the best palliative care providers in the world. She also happens to be refreshingly plain spoken.

We talk about many topics, including: how palliative care in bone marrow transplant and GI malignancies is unique, palliative care "pearls" in these populations, what it's like going into a "new" territory for palliative care, and what's next at MGH.

Yes, we have a podcast with Dame Cicely Saunders, the founder of the modern hospice movement. No, it's not one of the GeriPal podcasts, although that would have been a very impressive feat. Rather, Saunders is one of the "castaways" of BBC's Desert Island Discs originally published in 1994, slightly over a decade before her death (click here for the podcast).
The format of the show is that guests are asked to imagine they are cast aways on a desert island. They must pick recordings to take with them and discuss the reason why they are bringing them. They also discuss their lives and what they have learned along the way.

Saunders discussed her schooldays, how she trained as both a nurse and doctor, the development of St. Christopher's Hospice, euthenasia, and, shocking, how she fell in love with one of her patients.

I've had a chance to read a lot about Saunders, but there is something about hearing her voice that really makes recordings like these s…

Dr. Heidmann on the way to an apointment.
This sunny Saturday morning, I drove to a couple of house calls in my Northern California rural county, situated behind the redwood curtain. Covering both hospice and my program, Redwood Coast PACE (Program of All-Inclusive Care for the Elderly), the day is brisk with phone calls. I am listening to Bruce Springsteen read his autobiography, Born to Run, which makes the house call miles fly by. Bruce's story speaks to me about coming from almost nothing and practicing until you start to make something beautiful. He had an imperfect family, no money and little education. This hard scrabble existence is still a real one for so many people, including many of those I serve. And the fact is in small town America, providing healthcare can feel like a hard scrabble existence. People are astoundingly sick, reminding me of my rotations through San Francisco General Hospital, but without the resources of a large tertiary medical center. Lack of resour…

The Colorado Health Foundation has recently funded a host of proposals
around our state to increase advance care planning (ACP) in Colorado.The proposals I’ve heard about seem quite
innovative.Many, including ours, are
utilizing a volunteer workforce to implement the ACP.Some of us at the University of
Colorado, in partnership with our friends at the Denver Hospice, are working on a project
to create a “certification program” for advance care planning volunteers.I keep
thinking of it as being similar logistically to CPR certification.Obviously, that analogy is not perfect – ACP volunteers
don’t have to do chest compressions…and CPR volunteers don’t have to have
skills in communication.However, the
idea of a program where someone can learn the basics, practice, get feedback,
and become certified is really exciting to me. Through our development, we’ve begun to wonder and question our
assumptions about what a volunteer can do.We are hoping to get some
input.We’ve put together a very shor…

350 patients with newly diagnosed incurable cancers were randomized to early palliative care integrated with oncology care compared with usual oncology care. The patients had to be within 8 weeks of a diagnosis of incurable lung or noncolorectal GI (pancreatic, esophageal, gastric, or hepatobiliary) cancer. They also couldn’t have a history of therapy for metastatic disease, and had to have a reliatively good functional status (ECOG 0-2).

GeriPal (Geriatrics and Palliative care) is a forum for discourse, recent news and research, and freethinking commentary. Our objectives are: 1) to create an online community of interdisciplinary providers interested in geriatrics or palliative care; 2) to provide an open forum for the exchange of ideas and disruptive commentary that changes clinical practice and health care policy; and 3) to change the world.

No confidential patient information should be placed on GeriPal, nor should any confidential information be placed in the comments. The information provided on GeriPal is designed to complement, not replace, the relationship between a patient and and his/her own medical providers. The editors (Alex Smith and Eric Widera) reserve the right to remove comments that are deemed inappropriate due to the commercial, abusive, or offensive nature of a comment. If you think your comment was deleted for inappropriate reasons, please email either Alex or Eric.

GeriPal's mission is to improve the disemination of information in both geriatics and palliative medicine. GeriPal was created with the support of the Division of Geriatrics at the University of California San Francisco. Its content though is strictly the work of its authors and has no affiliation with or support from any organization or institution. All opinions expressed on this website are solely those of its authors & do not reflect the opinions of any academic institution or medical center. This web site does not accept advertisements. All email addresses collected by GeriPal for feed distribution will be kept confidential and will never be used for commercial reasons. If you reproduce the material on the website please cite appropriately. For questions regarding the site please email Alex Smith, MD (aksmith@ucsf.edu) or Eric Widera, MD (eric.widera@ucsf.edu)